Renal transplant patient survives a donor-derived abdominal invasive mucormycosis (Lichtheimia ramos a)

E M Spithoven; A H W Bruns; B J Petri; P J Haas; T Q Nguyen; F Hagen; A D van Zuilen

doi:10.1016/j.mmcr.2020.10.002

Renal transplant patient survives a donor-derived abdominal invasive mucormycosis (Lichtheimia ramos a)

Med Mycol Case Rep. 2020 Oct 23:30:39-42. doi: 10.1016/j.mmcr.2020.10.002. eCollection 2020 Dec.

Authors

E M Spithoven¹, A H W Bruns², B J Petri³, P J Haas⁴, T Q Nguyen⁵, F Hagen^{4

6}, A D van Zuilen¹

Affiliations

¹ Department of Nephrology, Internal Medicine, University Medical Center Utrecht, Utrecht, the Netherlands.
² Department of Infectious Diseases, Internal Medicine, University Medical Center Utrecht, Utrecht, the Netherlands.
³ Department of Vascular Surgery, Surgery Department, University Medical Center Utrecht, Utrecht, the Netherlands.
⁴ Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, the Netherlands.
⁵ Department of Pathology, University Medical Center Utrecht, Utrecht, the Netherlands.
⁶ Department of Medical Mycology, Westerdijk Fungal Biodiversity Institute, Utrecht, the Netherlands.

Abstract

Mucormycosis is a life-threatening invasive fungal infection, most commonly described in severely immunocompromised patients. It is characterized by rapid invasive growth of the fungus and often with fatal outcome. We report a case of a renal transplant recipient diagnosed with a donor-derived invasive mucormycosis. In this patient, we used a step-wise approach of withdrawal of immunosuppressants, antifungal induction therapy, extensive surgical debridement of all (potentially) infected tissue, abdominal irrigation of liposomal amphotericin B and interferon gamma. Due to rapid diagnosis and intensive therapy the patient survived.

Keywords: Interferon gamma; Renal transplant; Survival; mucormycosis.

Publication types

Case Reports